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To the Editor.—
I would like to respond to the editorial by David H. Spodick, MD (242:1658, 1979), in The Journal, suggesting that the time is ripe for a randomized clinical trial of percutaneous, transluminal coronary angioplasty. This technique has been introduced cautiously and with rather limited acceptance to date. It is true, as advocated by Dr Spodick, that balloon angioplasty presents many of the conditions for a properly designed, randomized controlled trial.There is, however, one major point where controlled trials of surgical and other technical procedures differ from trials of pills and injections. This is the problem of standardizing the procedure itself. Any technique must be developed, refined, honed, and perfected. Until this is achieved, everything else is meaningless.The great controversy regarding the reliability of the Veterans Administration Cooperative Study on coronary artery surgery arose primarily because the study was done too soon—before the technical aspects of
Webb WR. Study of Percutaneous, Transluminal Coronary Angioplasty. JAMA. 1980;243(14):1422. doi:10.1001/jama.1980.03300400012009